Individual provider Active NPI

Kerry A Hanner, LCSW

  • Clinical Social Worker
  • Bay Shore, NY
National Provider Identifier
1215971304
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0516241 Issued in NY
Practice address
1555 Sunrise Hwy
Suite #4
Bay Shore, NY 11706-6027
Phone
(631) 666-1615
Fax
(631) 666-1709
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R0516241 NY Primary

Addresses

Primary practice location

1555 Sunrise Hwy
Suite #4
Bay Shore, NY 11706-6027

Mailing address

1555 Sunrise Hwy
Suite #4
Bay Shore, NY 11706-6027
Phone (631) 666-1615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060705000202 NY Practitioner - Clinical Social Worker 6204848583 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0516241NYMDClinical Social Worker

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1215971304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 SUNRISE HWY",
            "address_2": "SUITE #4",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066027",
            "telephone_number": "631-666-1615",
            "fax_number": "631-666-1709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 SUNRISE HWY",
            "address_2": "SUITE #4",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117066027",
            "telephone_number": "631-666-1615",
            "fax_number": "631-666-1709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNER",
        "first_name": "KERRY",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0516241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.